Fibromyalgia can be a significant obstacle to sexual health among affected women, according to a recent study, which underscored that a lack of understanding among partners contributes to poor sexual relationships.

Pain or stiffness related to sexual acts also tends to give rise to a downward spiral of worries and fears related to sexuality, which then further aggravates the problem by reducing the desire for, and pleasure of, sex.

Still, not all women with fibromyalgia see lost sexuality as a problem, the study, “Perceptions about the sexuality of women with fibromyalgia syndrome: a phenomenological study,” showed. The work was published in the Journal of Advanced Nursing.

The research team at the University of Almeria in Spain used a qualitative approach to study sexuality among women with fibromyalgia. Six women underwent semi-structured interviews where researchers addressed various aspects of sexual health.

Not surprisingly, pain and stiffness were factors that played major roles in interfering with sexual activities, the women reported. Women also reported that sex and even foreplay caused them to get skin lesions and bruises. Pain can be felt before, during, and after sex, and sometimes deterred women from future sexual activity.

The abnormal pain response in fibromyalgia, in which a light touch can produce intense pain, is not always understood by partners, complicating sexual relationships. And stiffness after sexual intercourse can be so severe it prevents women from urinating, the study showed.

Some medications also make matters worse by increasing vaginal dryness or reducing sexual desire. Women over age of 45 can, however, also experience such symptoms because of their disease, as fibromyalgia is linked to an earlier menopause.

The participating women also mentioned bodily changes and a negative self-image as factors that contribute to poor sexual health.

The study showed that the majority of women thought of sexuality as part of a coping strategy. Women try to lead a life that is as normal as possible, including retaining their sexuality. On the opposite of the spectrum were women who had lost all interest in sexuality.

But the importance of sex was not constant. Women stated that they experienced crisis periods when they felt particularly low desire. During these times, characterized by more pain and depression, they wanted to be left alone by their partners.

These factors often led to strained relationships.

Some of the women reported that they viewed sex as a crucial part of keeping a relationship together, and so engaged in sex to please their partners. According to the study, this might not have the intended effect. When partners perceived the lack of pleasure, feelings of guilt and frustration could further strain relationships.

But despite the hardships, many women actively looked for options to improve the situation. Some focused more on foreplay to allow themselves to relax, while others spoke of finding sexual positions that did not lead to pain. Others spoke of physical exercise as a means of improving their sexual life.

A lack of understanding was mentioned at several points in the study, and so a focus on communication might also relieve problems, researchers suggested.

Although researchers addressed several limitations of the study, they underscored that much can be done to improve sexual health among women with fibromyalgia, including advising women on relaxation techniques and exercise programs.

“Despite limitations, sexuality is important for the identity and quality of life of women with fibromyalgia syndrome. Together with the physical symptomology, guilt, fear and a lack of understanding compromise the coping process. Women need the support of their partner, their socio-family environment and health professionals.” the researchers wrote.